World birth-weight curves better to assess risk in newborns of immigrants

November 10, 2014

Clinicians working with immigrant mothers and their babies may find that using birth-weight curves for specific regions based on the mother's birth country rather than Canadian curves are a more accurate predictor of risk of adverse events after birth, according to a large study published in CMAJ (Canadian Medical Association Journal).

"Potentially misclassifying the physiologically small, but healthy, newborn as small for gestational age may lead to unnecessary interventions and undue parental stress," states lead author Dr. Marcelo Urquia, Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and the Institute for Clinical Evaluative Sciences, Toronto, Ontario.

The birth weight of babies born to immigrant mothers, especially East and South Asian mothers, is often lower than that of babies whose mothers were born in Canada. This lower birth weight, however, does not necessarily translate into adverse outcomes.

The large study included 1 089 647 singleton births over 10 years in Ontario between April 2002 and March 2012. About one-third of babies (328 387) were born to immigrant mothers, of whom more than half (53.6%) were of East and South Asian birth. The remaining 761 260 infants were born to nonimmigrant mothers. About 10% (33 780) of infants born to immigrant mothers were classified as small for gestational age on both scales. These babies were more likely to die or suffer adverse events than heavier infants.

About 6% additional infants born to immigrant mothers were classified as small for gestational age on the Canadian birth-weight curve but not on the curve for the mother's country of origin.

Compared with newborns of Canadian-born mothers, newborns of immigrant mothers classified as small for gestational age on the Canadian curve had lower odds of adverse events such as a lengthy hospital stay or death, but babies classified as small on the world-region specific curves were more likely to die or suffer adverse events.

Approximately 5% of babies to immigrant mothers were deemed large for gestational age on both curves, and about 4% were classified as large on only the world-region specific curves. The deliveries of babies missed by the Canadian curve also had complications associated with large babies, such as perineal tears, shoulder dystocia and postpartum hemorrhage.

"World region-specific birth-weight curves seemed to be more appropriate than a single Canadian population-based curve for assessing the risk of adverse neonatal and obstetric outcomes among small- and large-for-gestational-age infants born to immigrant women. This was especially evident among infants whose mothers were from world regions where the birth-weight distribution differed markedly from that of the Canadian-born population, such as East and South Asian immigrants, who accounted for more than half of the births of immigrants in the study," write the authors.

"Estimating the number of newborns who may be spared unnecessary prolonged stay in hospital, special care, or referral for specialized pediatric or nutritional interventions, and the cost savings therein, is a worthwhile step in evaluating the impact of applying world region-specific curves in certain immigrant populations."
-end-


Canadian Medical Association Journal

Related Infants Articles from Brightsurf:

Most infants are well even when moms are infected by COVID-19
Infants born to women with COVID-19 showed few adverse outcomes, according to the first report in the country of infant outcomes through eight weeks of age.

Probiotic may help treat colic in infants
Probiotics -- or 'good bacteria' -- have been used to treat infant colic with varying success.

Deaf infants' gaze behavior more advanced than that of hearing infants
Deaf infants who have been exposed to American Sign Language are better at following an adult's gaze than their hearing peers, supporting the idea that social-cognitive development is sensitive to different kinds of life experiences.

Initiating breastfeeding in vulnerable infants
The benefits of breastfeeding for both mother and child are well-recognized, including for late preterm infants (LPI).

Young infants with fever may be more likely to develop infections
Infants with a high fever may be at increased risk for infections, according to research from Penn State College of Medicine.

Early term infants less likely to breastfeed
A new, prospective study provides evidence that 'early term' infants (those born at 37-38 weeks) are less likely than full-term infants to be breastfeed within the first hour and at one month after birth.

Infants are more likely to learn when with a peer
Researchers at the University of Connecticut and University of Washington looked at the mechanisms involved in language learning among nine-month-olds, the youngest population known to be studied in relation to on-screen learning.

Allergic reactions to foods are milder in infants
Majority of infants with food-induced anaphylaxis present with hives and vomiting, suggesting there is less concern for life-threatening response to early food introduction.

Non-dairy drinks can be dangerous for infants
A brief report published in Acta Paediatrica points to the dangers of replacing breast milk or infant formula with a non-dairy drink before one year of age.

Infants can't talk, but they know how to reason
A new study reveals that preverbal infants are able to make rational deductions, showing surprise when an outcome does not occur as expected.

Read More: Infants News and Infants Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.